Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family Health |
364SF0001X | 89 | Certified Clinical Nurse Specialist |
| NPI # | 1770761728 |
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| LBN Legal business name | MARY KELLEY INC | ||||||||
| Authorized official | CECELIA JOURDAN - (PRES/NP) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/01/2008 | ||||||||
| Last updated | 06/12/2008 - About 18 years ago | ||||||||
| Identifiers |
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